The Twenty-First Annual Symposium on Child Abuse & Neglect. Specialized Child Medical Training Track

Transcription

1 Presents The Twenty-First Annual Symposium on Child Abuse & Neglect Specialized Child Medical Training Track September 29 October 1, 2015 Lake Junaluska Assembly, NC Jointly provided by The School of Medicine of the University of North Carolina at Chapel Hill, Children s Advocacy Centers of North Carolina and the North Carolina Child Medical Evaluation Program

2 Child Medical Symposium CACNC Deana L. Joy Executive Director Angie Brown Training Coordinator NC Child Medical Evaluation Program, UNC Molly Berkoff, MD Medical Director Deborah Flowers, MSN, CPNP-PC Program Coordinator/Nurse Consultant The School of Medicine of The University of North Carolina at Chapel Hill CME Accreditation Statement: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The School of Medicine of The University of North Carolina at Chapel Hill, Children s Advocacy Centers of North Carolina and the NC Child Medical Evaluation Program. The School of Medicine of The University of North Carolina at Chapel Hill is accredited by the ACCME to provide continuing medical education for physicians. CME Credit Statement: The School of Medicine of The University of North Carolina at Chapel Hill designates this live activity for a maximum of AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other health professionals will receive a certificate of attendance from an AMA PRA Category 1 activity. These certificates are accepted by the NC Boards for physician assistants, nurse practitioners, nurses, pharmacists, and respiratory therapists. Other health care providers may also be able to use these certificates, depending on their particular license requirements. (License requirements are subject to change. Participants should contact their licensing boards for specific questions. UNC and its partners are not responsible for changes in license requirements.) Target Audience & Purpose: This training is targeted for registered CMEP providers and is geared to provide specialized medical education that will assist in the evaluation, diagnosis and management of children with a suspicion of maltreatment. CME Disclosure Statement: The planners and presenters for this activity have no financial relationships with commercial interests as defined by the ACCME. 1

3 Learning Objectives: The information presented at this education activity should be able to improve your ability to: (1) Recognize and document characteristics of child sexual abuse, physical abuse and neglect; (2) Formulate differential diagnoses beyond abuse and neglect; (3) Demonstrate increased knowledge and skills related to exam techniques of child abuse victims; and (4) Implement standard treatment guidelines. ADA Statement: The University of North Carolina at Chapel Hill and CACNC are committed to equality of educational opportunity and do not discriminate against applicants, students, or employees on the basis of race, color, religion, sex, national origin, age, disability, veteran s status, or sexual orientation. If you require reasonable accommodations for a disability in order to participate fully in this continuing educational activity, please call (336) no later than September 19, 2015 or attach a note to your registration form. Lodging Information: Rooms are available on site at Lake Junaluska at the Terrace and Lambuth Inn at the NC state rate (requires 3 night stay; rates slightly higher for 1-2 night stay). Call (800) or visit to reserve lodging online (use Access/Group Code #7298 for group rate). The deadline for online lodging reservations is August 28, After August 28 th, you must call Lake Junaluska to reserve room. Rooms are available on a first come, first serve basis. Please make your reservations early. Training Location: Lake Junaluska Retreat & Conference Center The Terrace & Harrell Center 91 N. Lakeshore Drive Lake Junaluska, NC Visit to download the facility map and driving directions. Featured Speaker: Christopher Greeley, MD, MS, FAAP Christopher Spencer Greeley received his undergraduate degree from Hobart College, medical degree from the University of Virginia, and completed his internship and residency in pediatrics at Vanderbilt University. He received a Masters in Clinical Research, with a special concentration on Comparative Effectiveness Research, from the University of Texas Health Science Center in Houston. Board certified in General Pediatrics and Child Abuse Pediatrics; he is a member of the AMA and the AAP. He is Professor of Pediatrics in the Center For Clinical Research and Evidence-Based Medicine in the Department of Pediatrics at the University of Texas Health Science Center at Houston. Dr. Greeley currently serves on the AAP Section on Child Abuse and Neglect Executive Committee, and is the co-chair of the Texas Pediatric Society Committee on Child Abuse and Neglect. Dr. Greeley was the 2006 Ray E. Helfer Award winner. Dr. Greeley was appointed by Texas Lt. Governor Dewhurst to the state wide Blue Ribbon Task Force on Child Abuse and Neglect Prevention and served as the Chair and was reappointed in December 2012 by Governor Perry. He also served as the Chair of Board of Directors of Prevention Child Abuse America from He is also the chair of the state chapter for the American Professional Society on the Abuse of Children. His research is in the recognition and prevention of child physical abuse, in particular, Abusive Head Trauma. He lectures locally, regionally, nationally and internationally on various topics regarding child maltreatment, socioeconomic factors associated with childhood adversity, and evidence-based medicine. 2

4 Symposium Agenda Medical Track Monday, September 28, :30 6:30 p.m. Symposium Check-In (optional) The Terrace Lobby, 2 nd Floor Tuesday, September 29, :30 9:00 a.m. Check-In/light breakfast The Terrace, 3 rd Floor Balcony Registered attendees for this track have the option of attending the medical workshops or any of the multi-disciplinary workshops offered throughout the symposium. However, CME credits will only apply to the approved medical and multi-disciplinary workshops listed in this brochure. Please visit for a complete listing of all MDT workshops. 9:00 9:15 a.m. Welcome & Announcements Harrell Center Auditorium, Lower Level 9:15 10:00 a.m. The Value & Impact of CACs Chris Newlin, MS, LPC Executive Director, National Children s Advocacy Center, Huntsville, AL The child abuse field and especially the work of Children s Advocacy Centers are constantly changing in response to emerging research, practice considerations, and the broader culture. The Children's Advocacy Center Model was developed in 1985 in an effort to dramatically improve the effective response to child abuse while prioritizing the alleged victims' experience and honoring their rights. There are now more than 825 Children's Advocacy Centers throughout the United States, and more than 60 operating internationally in 23 countries. This session will focus on the dramatic impact of child maltreatment on our nation s health and economy, and also review emerging practices/issues and significant evidence supporting the CAC and Multidisciplinary Team Model. 10:00 10:15 a.m. Break 10:15 11:45 a.m. Recent Research Regarding Child Abuse Investigations Chris Newlin, MS, LPC Executive Director, National Children s Advocacy Center, Huntsville, AL This workshop is intended for all professionals who are involved in the investigation and prosecution of child abuse. We are working in a continually changing field, and it is critical that direct service providers stay abreast of the current research affecting our work. This workshop will provide a general review of recent research affecting child abuse investigations and prosecutions, and challenge the attendees to relate this information to their current practices in the field. 11:45 1:15 p.m. Luncheon The Terrace, 3 rd Floor 1:15 2:45 p.m. The State of Children in America Christopher Greeley, MD, MS, FAAP, Professor of Pediatrics, Center for Clinical Research and Evidence-Based Medicine Department of Pediatrics, University of Texas Health Science Center at Houston This talk will be an overview of the impact of childhood adversity on the child and the child as an adult. It will focus on common threats to child well-being (poverty, violence and neglect) and will explore how socioeconomic adversity and inequality has measurable impacts on children and their families. The talk will end with ways pediatricians can begin to address this in the health care system. At the conclusion of this presentation, participants will be able to appreciate (1) the role that childhood adversity plays in the life trajectory of children, (2) how socioeconomic inequality has measurable effects on growing children and their families; and (3) how the healthcare provider can begin to address adversity in their practice. 3

5 Tuesday, September 29 th continued 2:45 3:00 p.m. Break 3:00 4:30 p.m. External Signs of Abuse & Neglect Christopher Greeley, MD, MS, FAAP, Professor of Pediatrics, Center for Clinical Research and Evidence-Based Medicine Department of Pediatrics, University of Texas Health Science Center at Houston This talk will cover the basics of the external signs of child physical abuse. The talk will emphasize the medical literature behind bruising in children, include typical abusive patterns as well as typical accidental patterns of bruising and also look at burn patterns. The participant will be presented different patterns of inflicted burns and ways to distinguish inflicted from accidental burns will be discussed. At the conclusion of this presentation, the participant will be able to (1) understand ways to distinguish accidental from inflicted bruises, (2) understand some ways to distinguish accidental from inflicted burns; and (3) recognize some common external manifestations of neglect. Wednesday, September 30, :45 8:30 a.m. Check-In/light breakfast The Terrace, 3 rd Floor Balcony 8:30 10:00 a.m. Demystifying the Medical Literature: Separating the Wheat from the Chaff Christopher Greeley, MD, MS, FAAP, Professor of Pediatrics, Center for Clinical Research and Evidence-Based Medicine Department of Pediatrics, University of Texas Health Science Center at Houston The cornerstone of high-quality clinical care and evidence-based medicine is an appreciation of the available evidence in the medical literature. Not all published reports are of the same quality. This talk will discuss the different strengths and weaknesses within the medical literature and provide the learner with some guidance on approaching critical literature appraisal. Many examples from the published literature will be used to highlight important points. At the conclusion of this presentation, the participant will be able to (1) describe the basic structure and use of the medical literature, (2) highlight the strengths and weaknesses of the peer review process; and (3) highlight some of the traps and fallacies which exist within the published medical literature. 10:00 10:15 a.m. Break 10:15 11:45 a.m. Abusive Head Trauma: The Debate Christopher Greeley, MD, MS, FAAP, Professor of Pediatrics, Center for Clinical Research and Evidence-Based Medicine Department of Pediatrics, University of Texas Health Science Center at Houston Abusive Head Trauma (AHT), historically called Shaken Baby Syndrome, is a condition in which a young child (usually in the first year of life) is injured by violent force by a caretaker. The clinical findings include: injury to the brain, fractures (typically to the ribs and growth plates of the bones), bleeding in the eyes and external injury (bruising). Over the past decade there have been news reports indicating that the existence of AHT has been questioned in the courtroom. This talk will discuss the science behind AHT and frame some of the criticisms raised in the courtroom. At the conclusion of this presentation, the participant will (1) appreciate the scope of the medical/legal debate surrounding Abusive Head Trauma ( shaken baby syndrome ), (2) understand some of the criticisms of the theory of Abusive Head Trauma which are raised in the legal setting and the medical literature used to support the skeptical position; and (3) appreciate the role of high quality medical literature appraisal in the medico-legal setting. 11:45 1:15 p.m. Luncheon The Terrace, 3 rd Floor 1:15 2:15 p.m. Updates from CMEP Molly Berkoff, MD, Medical Director, NC Child Medical Evaluation Program at UNC, Chapel Hill, NC Sara Sinal, MD, Pediatric Consultant & Lead CME Quality Consultant, NC Child Medical Evaluation Program at UNC, Chapel Hill, NC Speakers will discuss recent CQI issues related to CME and CFEs as well as changes to program function and structure. All medical and mental health providers are encouraged to attend this seminar. 2:15 2:30 p.m. Break 4

6 Wednesday, September 30 th continued 2:30 5:00 p.m. Review, Photographic Illustrations and Discussion of the Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused (Adams, Kellogg, Farst, Harper, Palusci, Frasier, Levitt, Shapiro, Moles, Starling) Karen St. Claire, MD Medical Director, Duke Child Abuse & Neglect Program Medical Director, Duke Child Abuse and Neglect Medical Evaluation Clinic (CANMEC) Associate Professor of Pediatrics, Duke University Health System This presentation will review the new Adams, et al. article Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused, which has been accepted for publication by the Journal of Pediatric and Adolescent Gynecology for later this year. This article will be briefly contrasted with the previous versions of Joyce Adams guidelines to highlight notable changes in and on-going refinement of these guidelines for sexual abuse examinations, classification of physical findings, classification and treatment of sexually transmitted infections and evidence-based conclusions. Case photographs will be used to illustrate the physical exam findings that are discussed in the article. Significant changes in terminology and interpretation of findings will be highlighted and discussed. At the end of the presentation, the audience will participate in an exercise to determine the updated diagnostic classification of physical findings and sexually transmitted infections from several Duke CANMEC sexual abuse cases. Thursday, October 1, :45 8:30 a.m. Check-In/light breakfast The Terrace, 3 rd Floor Balcony 8:30 10:00 a.m. When the Pieces Don t Fit: Understanding Medical Child Abuse (Part 1 of 2) Patsy R. Lightle, BA, MT Training Coordinator, University of South Carolina Law School Children s Law Center, Columbia, SC Nancy A Henderson, MD Medical Director of the Division of Forensic Pediatrics, Greenville Health System, Greenville, SC & Medical Director for Children s Advocacy Center of Spartanburg, SC and the Julie Valentine Center in Greenville, SC This workshop will define Medical Child Abuse and provide a checklist of perpetrator characteristics, discuss the importance of medical diagnosis, documentation and preparation of an investigative timeline and provide a multidisciplinary approach to case planning and management to better handle a MSBP case to include intervention, child protection and investigation. 10:00 10:15 a.m. Break 10:15 11:45 a.m. When the Pieces Don t Fit: Understanding Medical Child Abuse (Part 2 of 2) Patsy R. Lightle, BA, MT Training Coordinator, University of South Carolina Law School Children s Law Center, Columbia, SC Nancy A Henderson, MD Medical Director of the Division of Forensic Pediatrics, Greenville Health System, Greenville, SC & Medical Director for Children s Advocacy Center of Spartanburg, SC and the Julie Valentine Center in Greenville, SC Refer to full description above. This is a continuation and conclusion of the medical child abuse topic. This brochure and the brochure for multi-disciplinary workshops are available in electronic form on our website at 5

7 Child Medical Registration Form A separate form is required for each participant. This form may be duplicated. Name (as it will appear on your name badge): Title: Agency: Work Address: City: State: Zip: Telephone: Registration Fees: Registration fee includes symposium materials, light breakfast & coffee each morning, lunch on September 29 & 30, breaks and AMA PRA Category 1 CME credits or CEU credits. Registration for this track also provides access to any multi-disciplinary workshop offered at the symposium. Pre-registration deadline is August 31, Symposium fees increase if registration is not postmarked by this deadline. There will be no on site registration. If payment will be delayed, please contact the CACNC office to communicate this delay and make necessary arrangements to qualify for pre-registration rates. There will be no refunds after August 31; registration may be transferred to another person. Please check the appropriate registration option: Postmarked by 8/31 Postmarked after 8/31 Entire Medical Symposium $295 $315 Postmarked by 8/31 Postmarked after 8/31 Two days only Child Medical track $270 $285 Please specify: 9/29 9/30 10/1 Postmarked by 8/31 Postmarked after 8/31 One day only Child Medical track $160 $170 Please specify: 9/29 9/30 10/1 Please indicate any special dietary needs, if applicable: Do not forget to make your reservation for lodging. Symposium fees do not include accommodations! It is also recommended that participants dress to accommodate warm or cool training room temperatures. CME Credit Statement: The School of Medicine of The University of North Carolina at Chapel Hill designates this live activity for a maximum of AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other health professionals will receive a certificate of attendance from an AMA PRA Category 1 activity. These certificates are accepted by the NC Boards for physician assistants, nurse practitioners, nurses, pharmacists, and respiratory therapists. Other health care providers may also be able to use these certificates, depending on their particular license requirements. License requirements are subject to change. Participants should contact their licensing boards for specific questions. UNC and its partners are not responsible for changes in license requirements. Make Checks Payable to: CACNC Return this form with payment to: CACNC P.O. Box 6312 High Point, NC

8 General Information Registration: Sign up now space is limited! There is limited availability for this specialized medical training. Registration is on a first come, first serve basis. A separate form is required for each participant. Call the office or check our website at for updates on space remaining for the CMEP training. Workshop selection Paid registration for the medical training provides each participant the choice of attendance to any of the medical workshops or any of the multi-disciplinary workshops. For a complete listing of symposium offerings, please visit to view the MDT workshops (located in the Training section). Mail in registration with payment Payment is required to guarantee your registration. Payment should be mailed with your completed registration form; however, if payment will be delayed, contact Angie Brown at (336) or at Apbrown@northstate.net to communicate this delay and make necessary arrangements to qualify for the preregistration rates, if applicable. Fees & Payment: Registration fees include symposium materials, light breakfast and coffee each morning, lunch on September 29 and 30, afternoon breaks and CME credits. The early registration deadline is August 31, 2015! Registration forms must be postmarked by this date to qualify for the early registration rates. If your registration is postmarked after this date, additional registration fees will apply. Contact Angie Brown if you have concerns about meeting this deadline. Make checks payable to CACNC. At this time we are unable to accept credit card payments. Please make checks payable to CACNC and mail to: CACNC P.O. Box 6312 High Point, NC An confirmation will be sent upon receipt of registration forms and payment (or phone confirmation if is not provided). If you fail to receive such notice in a timely manner, please contact the CACNC office. CACNC recommends that you do not make air travel arrangements prior to receiving a receipt of payment or confirmation. CACNC is not responsible for any travelrelated costs. 7 Cancellation Policy/Refunds: CACNC reserves the right to cancel or postpone any course due to unforeseen circumstances. In the event of cancellation or postponement, CACNC will fully refund registration fees but it is not responsible for any related costs or expenses to participants, including cancellation fees assessed by hotels, airlines, rental car or travel agencies. If you cannot attend for any reason, you must cancel your symposium registration in writing ( acceptable) and refunds, if applicable, will be issued after the symposium. There will be no refunds granted after August 31, 2015; registration may be transferred to another person. Please contact the CACNC office as soon as possible with this change to ensure that we have symposium materials (badges, registration) printed with the correct name. Lodging: Symposium registration does not include lodging. All training activities will be held at the Terrace and the Harrell Center Auditorium (directly across from the Terrace) at Lake Junaluska. Rooms are available at the Terrace and the Lambuth Inn at the NC state rate (requires a 3 night stay; rates slightly higher for 1-2 night stay). Call (800) or visit to reserve lodging online (use Access/Group Code # 7298 for group rate). The deadline for online lodging reservations is August 28, After this date, please call for reservations. Rooms are available on a first come, first serve basis. Please make your reservations early! On Site Hotel Registration If you are staying on the Lake Junaluska properties, please check in at the Welcome Center (at the main entrance) upon your arrival for the symposium. If the Welcome Center is closed, the hotel staff will handle check-in. On Site Symposium Check-In: Participants are encouraged to pick up symposium materials at the Terrace lobby on Monday evening, September 28, from 4:30 6:30 p.m. The medical registration area will open daily at 8:00 a.m. Questions? Contact Angie Brown, Training Coordinator, at Apbrown@northstate.net or at the CACNC office at (336) with any questions or concerns. You may also visit our website at for symposium updates.